AB1377 FELDENKRAIS AWARENESS THOUGH MOVEMENT INTERVENTION FOR FIBROMYALGIA SYNDROME: A PROOF-OF-CONCEPT STUDY
Authors: V. Giorgi, S. Farah, F. Salaffi, P. Sarzi-Puttini
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The Feldenkrais Method is a form of awareness through movement (ATM) which aims at increasing awareness about spatial and kinesthetic relationships among body segments and the environment thought verbally guided movements [1]. Fibromyalgia syndrome (FM) is a form of chronic widespread pain associated to a variety of ancillary symptoms, among which fatigue, sleep disturbances and regional pain syndromes are preponderant. Lately, increasingly more attention has been drawn on mind-body interventions and meditative movement therapies for FM treatment [2]. ATM application for chronic pain has been promising but with low quality studies [3,4]. <h3>Objectives</h3> The aim of this study was to explore the effectiveness of ATM for FM patients after 4 months of ATM activity; in particular, the proof-of-concept design aims at determining the domains for which an ATM-based intervention may be effective for FM patients. <h3>Methods</h3> This is a proof-of-concept, observational, non-controlled prospective study which lasted 6 months. Participants were recruited by the Italian Fibromyalgia Syndrome Association (AISFOdv), a non-profit patient organization, through social media advertising. After signing the informed consent, they were divided into eleven groups of eleven/twelve patients each. Two Feldenkrais teachers were assigned to each group. All patients attended an ATM course lasting 15 lessons, with a lesson every week, 1.5 h long (from January to May, 2021). The sessions were entirely virtual platform- based and live. Clinimetric tests and patient-reported outcome tests were administered at baseline and at the end of the intervention. <h3>Results</h3> One hundred twenty-eight FM patients (mean age 54 years old, 2% males) participated in the study. A statistically significant improvement was found in FM-specific measures (Polysymptomatic Distress Scale, PDS) (p=0.003) and the Pain Catastrophization Scale (PCS) (p=0.020); coherently, the amelioration in the Revised Fibromyalgia Impact Questionnaire (FIQR) almost reached statistical significance (p=0.08). The logistic regression analysis found a correlation between PDS, fatigue and anxiety measures; PCS, years from diagnosis and anxiety. <h3>Conclusion</h3> In conclusion, ATM could improve FM-specific measures and pain-related catastrophizing. Improving awareness about one's one body and movements through ATM sessions may have helped FM patients to improve their cognitive attitude towards their pain condition, embracing a more positive, hence less catastrophizing attitude; furthermore, ATM could benefit FM patients because of its induction of muscular relaxation [5]. Further studies are needed to identify FM subgroups in order to find personalized targets that can be used to guide treatments. <h3>References</h3> [1]Zahid S, Khan Y. Feldenkrais method: utilisation and evidence base. <i>J Geriatr Care Res</i> 2020;<b>7</b>:93–5. [2]Bravo C, Skjaerven LH, Guitard Sein-Echaluce L, et al. Effectiveness of movement and body awareness therapies in patients with fibromyalgia: A systematic review and meta-analysis. Eur J Phys Rehabil Med 2019;55:646–57. [3]Malmgren-Olsson EB, Armelius BÅ, Armelius K. A comparative outcome study of body awareness therapy, feldenkrais, and conventional physiotherapy for patients with nonspecific musculoskeletal disorders: Changes in psychological symptoms, pain, and self-image. Physiother Theory Pract 2001;17:77–95 [4]Öhman A, Åström L, Malmgren-Olsson EB. Feldenkrais® therapy as group treatment for chronic pain - A qualitative evaluation. J Bodyw Mov Ther 2011;15:153–61 [5]Brummer M, Walach H, Schmidt S. Feldenkrais 'functional integration' increases body contact surface in the supine position: A randomized-controlled experimental study. Front Psychol 2018;9:2023. <h3>Acknowledgements</h3> We would like to thank the teachers of the Italian Association of Teachers of the Feldenkrais Method (AIIMF) for their collaboration in this study. <h3>Disclosure of Interests</h3> None Declared.